People often ask me what AAC system I use. For some reason, they almost never* ask me what AAC systems I use (the difference is the plural.)
This is true in a bunch of different situations where people might ask what system I use. In situations where I can give an open-ended answer, I can explain my actual use: lots of different systems and tools. In situations where I have to give a closed-form answer (mostly to do with surveys and other research), the assumption of a single system or a single device is a bigger problem, because it means I (and quite a few other people) can't accurately give the information people are trying to ask for.
However, the assumption of a single system or a single device for AAC is still a problem when I can answer with the actual list of several things I use. It's still a problem because the expectation of one system makes options like guided access seem sensible: if a person only uses one app to communicate, then locking them into that one app could keep the device locked to meeting their communication needs. But if a person uses many communication options, including multiple programs on the same device (not all of which were necessarily designed for AAC or are necessarily considered AAC software), then locking a device to only one of those programs doesn't sound nearly as helpful! What if I need one of the ones you didn't pick? Or what if I need more than one AAC tool simultaneously? My current record for simultaneous use is four devices at once: three with Flip Writer, one sitting with each of the three people I was at dinner with, plus my MacBook that I was typing a longer response on.
It's also a problem because the expectation of one system leads people to reject options that can do a great job meeting some of their needs some of the time because they have some needs or situations where it won't work at all. Having one program that does a so-so job at all the things I want to do is not necessarily better than having six programs that are all very good at one or two of the things and switching between them depending on which thing I need to do. On a similar note, it means people might stop looking after they've found one thing that mostly works. Maybe we found a symbol-based system that works, or we found a text-based system that works, but it would actually be best to have both for different situations!
Thinking in terms of use cases for AAC options instead of whether they somehow meet all my needs (none do) also means that situational use is much more common for me than true device or program abandonment. It also lets us draw a distinction between options that we haven't used in a long time because their use case hasn't come up in a long time (like the whiteboard I regularly used during my masters program) and options that aren't ideal for any of our use cases (the free version of Verbally just did not work for me). An option I would dust off as soon as its rare or narrow use case comes up isn't actually abandoned -- even if it might look that way for months or years. An option that doesn't work for any of my use cases is abandoned -- even if I only finished testing it to figure that out an hour ago.
As an example, instead of just theory, here are some tools I currently use to communicate and their use cases:
- Mouth words**: I am a part-time AAC user. I speak for most presentations or performances. I also use it for most one-on-one conversations. Because speech is expensive for me, it may not still be available after a presentation or performance, and it may not be particularly effective even if it is still technically possible.
- Flip Writer: In most face to face settings, I want to show people what I typed without speech generation. Flip Writer flips what I type and makes it bigger while I'm writing, in any language I have a system keyboard for. It has speech generation, but it usually only works in English. I have not figured out the pattern for the occasional times that Flip Writer has done speech generation in Mandarin for me.
- Proloquo4Text: When I am giving a presentation with AAC, saved phrases are important and I probably want speech generation. Presentations are my main use case for Proloquo4Text on my iPad. I use Proloquo4Text on my Mac when I want speech generation in a video call, or when doing certain kinds of scenes from Augmentative and Alternative Improvisation.
- Proloquo: I use this for Augmentative and Alternative Improvisation. I don't use it for my personal communication needs off-stage.
- Chat functions: Chat functions in video calls aren't designed for AAC per se, but if I'm in an environment where people actually pay attention to the chat, I tend to prefer this to using speech generation on video calls. The more people there are in a video call, the more likely I am to need to use the chat as opposed to being able to coordinate listening and turn-taking and deciding what to say and speech all at once.
- Projectors: Sometimes, I am in an environment where people's statements are being captioned for access reasons. (More environments should do this!) Many real-time captioners, especially the automated ones, struggle with AAC voices. Other times, I am in an environment with people who may not be used to AAC voices -- like my neuroscience classmates in graduate school. Projecting my actual screen means that my exact words are available visually. I also tend to prefer not to use speech generation with my AAC, both for gender reasons and for turn-taking reasons: I have the unusual preference of not treating my typing/composing as part of me talking, both in terms of whether you're interrupting me and in terms of whether I'm interrupting you. (It's only fair if it goes both ways!)
- Word processing software: If I don't need speech generation, then a projector is getting used with a word processor document, not Proloquo4Text, and then I'm making the font large. I'll also use word processing software on my computer to type longer responses where the speed increase from working with a physical keyboard matters, or if I need more AAC devices at once than I have iDevices with me.
- White board and marker: If I'm in a room that has a white board, doing an activity where being close to the white board is reasonable, writing on that board with a marker is likely to be my preference! This use case doesn't come up nearly as often now as it did when I was working on my masters in math, but it's still a true preference when it comes up.
- Pen and paper: This is distinct from white board and marker for three main reasons. First, the white board gives a stronger "I am composing a message!" signal than pen and paper does in many circumstances. Second, pen and paper is more portable than a white board -- if I'm planning on pen and paper, I'm likely to have a pocket full of index cards. Finally, my white board handwriting is significantly different from (more legible and less painful than) my pen and paper handwriting. I mostly use pen and paper in environments where electronics should ideally not be used (chemistry labs, animal research labs), where space is a serious issue, where leaving my message with the person is valuable (other teaching environments), if it's too bright for someone to realistically read my screen, or if my electronics have dead/nearly dead batteries.
- eSpeak: If I need speech generation in Mandarin Chinese, this is my go-to. I am 100% annoyed about its inability to detect which pronunciation should be used for characters which are pronounced differently based on context. However, this problem is not unique to eSpeak or Mandarin: English-language AAC software tends to have the same problem with words like "read" and "live."
- Texting/email/messenger systems: Tools designed for asynchronous text-based communication are still designed for text-based communication! I can use them to communicate regardless of the current status of my mouth word.
This is a list, in no particular order, of eleven communication options. Admittedly, only three of them are actually designed for AAC, and one of them is really only used in combination with others. Still, this is very much not a combination where I could give a singular answer of what AAC system I use.
* I did say almost, and I think the exceptions are important. So here are the ones I know of:
- The survey this poster is based on did ask about the use of multiple tools for AAC. It's not really addressed in the poster itself, which focused on whether the communication participation item bank (CPIB) reflects experiences of intermittent, unreliable, insufficient, and expensive speech, but the survey did cover it.
- When CommunicationFIRST is involved in a survey that asks how we communicate, it's been a check-multiple question that includes a fill-in 'other' category. Spoken language makes the list, too!
- The Augmentative and Alternative Communication (AAC) Peer Support Project has a poster about this type of result; most AAC users reported using 5-10 methods. I believe the 11 things I list in this post would condense into 5 items on that survey.
- Bridging the Social & Technical Divide in Augmentative and Alternative Communication (AAC) Applications for Autistic Adults supported listing multiple options. Every participant listed multiple options for their current AAC, most including multiple options that were designed for AAC. I did give feedback on the questions. I don't remember if letting people pick multiple options to describe their current AAC was one of my suggestions.
- This study, sponsored by Tobii Dynavox about the impacts of AAC in Sweden, logically must have supported multiple selection on both AAC hardware and software for the numbers in the report to work -- both hardware and software numbers add up to well over 100%.
** Based on the results of our terminology survey, "mouth words" is a term to think before using. As a part-time AAC user describing my own use of spoken language: I have thought and yes I do want to use the term that makes the option of spoken language sound a bit more marked or weird.
